Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | TX14388 | TX |
NPI | 1154440691 |
---|---|
Provider Name | Dr. Frederick Philip Brown |
First Address | San Antonio, TX 78255-3449 |
Second Address | San Antonio, TX 78211-1406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |